Safety and Tolerability of Galantamine in Possible Alzheimer’s Disease with or without Cerebrovascular Disease and Vascular Dementia in Thai Patients
Vorapun Senanarong MD, FRCP*, Niphon Poungvarin MD, FRCP*, Kammant Phanthumchinda MD**, Nuntika Thavichachart MD, MSc***, Siwaporn Chankrachang MD****, Rungnirund Praditsuwan MD*****, Samart Nidhinandana MD******
Affiliation : * Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Division of Neurology, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand *** Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand **** Division of Neurology, Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand ***** Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ****** Division of Neurology, Department of Medicine, College of Medicine, Pramongkutklao Hospital and College of Medicine, Bangkok, Thailand
The purpose of this study was to explore factors that influence the clinical safety and tolerability associated with galantamine administration in Thai Alzheimer’s disease patients with or without cerebrovas- cular disease and vascular dementia. This was an analysis of previous study. Tolerability and safety profile were analyzed according to sex, age, body weight, Thai mental state examination (TMSE) score, Alzheimer’s disease assessment scale-cognitive subscale (ADAS-cog) score, and Alzheimer’s disease cooperative study/ activities of daily living (ADCS/ADL) score. The most common adverse events were nausea, dizziness, and weight loss which more often occurred during the dose-escalation phase. Mean body weight lost at week 24 was 0.9 kg. Sex, age, body weight, and ADAS-cog score did not influence the incidence of any adverse events. Dizziness was more likely to occur in patients with low TMSE and high ADCS/ADL score (p = 0.02 and p = 0.050, respectively). Patients with TMSE score equal or higher than 23 more often experienced muscle cramps and fatigue than who had TMSE lower 23 (p < 0.05). However, flexible dose escalation of galantamine with a 4-week schedule was safe and well tolerated in Thai AD patients.
Keywords : Alzheimer disease, Dementia, Vascular, Drug tolerance, Galantamine, Safety
